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1013323336
DUSTIN WADE
SHAWNEE, OK
NPI
1013323336
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: OK 91102)
Enumeration Date
2014-07-08
Last Update Date
2023-06-13
Business Address
DUSTIN WADE
2508 N HARRISON ST
SHAWNEE, OK 74804-3131
Phone number: 405-585-2030
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Mailing Address
DUSTIN WADE
821 E VETERANS MEMORIAL HWY
BLANCHARD, OK 73010-9215
Phone number:
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